The effect of premature luteinizing hormone increases among high ovarian responders undergoing a gonadotropin‐releasing hormone antagonist ovarian stimulation protocol

Geng, Yichao; Lai, Qiaohong; Yang, Xiufen; Jin, Lei

doi:10.1002/ijgo.12485

Cited by 12 publications

(22 citation statements)

References 25 publications

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“…( 8 ) and Geng et al. ( 15 ) both reported a high incidence of premature LH rises (15.6 and 16.2%, respectively), whereas another study, involving ganirelix, showed a much lower incidence (1.4%) ( 16 ). In the present study, 82 patients (8.03%) showed premature LH increases during GnRH antagonist treatment; this finding was in line with those of Dovey et al.…”

Section: Discussionmentioning

confidence: 97%

“…The effect of a premature LH rise on pregnancy outcome remains controversial. A prospective study of 314 high ovarian responders undergoing a fixed GnRH-antagonist protocol, showed a lower clinical pregnancy rate in patients experiencing a premature rise in LH ( 15 ). The same result was found in women undergoing the flexible GnRH antagonist protocol; similarly, reduced rates of ongoing pregnancy rate were also reported previously ( 7 ).…”

Section: Discussionmentioning

confidence: 99%

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A Premature Rise of Luteinizing Hormone Is Associated With a Reduced Cumulative Live Birth Rate in Patients ≥37 Years Old Undergoing GnRH Antagonist In Vitro Fertilization Cycles

Gao

Wang

et al. 2021

Front. Endocrinol.

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This is a retrospective cohort study included 1021 patients underwent a flexible GnRH antagonist IVF protocol from January 2017 to December 2017 to explore the effect of a premature rise in luteinizing hormone (LH) level on the cumulative live birth rate. All patients included received the first ovarian stimulation and finished a follow-up for 3 years. A premature rise in LH was defined as an LH level >10 IU/L or >50% rise from baseline during ovarian stimulation. The cumulative live birth rate was calculated as the number of women who achieved a live birth divided by the total number of women who had either delivered a baby or had used up all their embryos received from the first stimulated cycle. In the advanced patients (≥37 years), the cumulative live birth rate was reduced in patients with a premature rise of LH (β: 0.20; 95% CI: 0.05–0.88; p=0.03), compared to patients (≥37 years) without the premature LH rise. The incidence of premature LH rise is associated with decreased rates of cumulative live birth rate in patients of advanced age (≥37 years) and aggravated the reduced potential of embryos produced by the advanced age, not the number of embryos.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

A Premature Rise of Luteinizing Hormone Is Associated With a Reduced Cumulative Live Birth Rate in Patients ≥37 Years Old Undergoing GnRH Antagonist In Vitro Fertilization Cycles

Gao

Wang

et al. 2021

Front. Endocrinol.

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“…It is therefore reasonable to conclude that a portion of the excessive responders in this study might be diagnosed with PCOS. Geng et al [ 28 ] reported that 21% of PCOS patients show premature luteinization, especially before follicle maturation, suggesting poor oocyte quality in PCOS patients [ 29 ]. Additionally, the metabolic similarities observed in the follicle fluid between excessive responders and PCOS patients indicate that metabolic alteration, among other things, could impair the quality of at least a portion of oocytes and embryos in excessive responders [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of Interval between Human Chorionic Gonadotropin Priming and Ovum Pick-up on the Euploid Probabilities of Blastocyst

Lee

Chen²,

Huang³

et al. 2020

JCM

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This retrospective study attempts to elucidate the relevance of the interval between human chorionic gonadotropin priming and oocyte pick-up (hCG-OPU) to the euploidy probability of biopsied blastocysts in preimplantation genetic tests for aneuploidy (PGT-A) cycles. A total of 1889 blastocysts from 511 patients undergoing PGT- A cycles were used. An analysis of generalized estimating equations (GEE) was used to identify whether the hCG–OPU interval is associated with euploidy probabilities of blastocysts. Accordingly, maternal age (OR: 0.925, 95% CI: 0.903–0.948, p < 0.001) and the hCG–OPU interval (OR: 1.138, 95% CI: 1.028–1.260, p = 0.013) were the two significant factors associated with the euploidy probabilities. The Cochran-Armitage trend test demonstrated that the blastocyst euploidy percentage increased progressively with the increasing hCG-OPU interval in normal responders (p = 0.006) and advanced maternal age (age ≥38 years; p = 0.020) groups. In normal responders, the euploidy rate was highest in the 38–39 h interval (43.1%, 47/109). In contrast, the euploidy rate was lowest in the 34–35 h interval (28.7%, 29/105). In conclusion, the present study demonstrated that at an hCG-OPU interval between 34–39 h, the longer the hCG-OPU interval, the higher the probability of euploidy for blastocysts.

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“…A recent retrospective study was conducted in patients in whom hyper response is predicted with higher antral follicle count (≥ 15) in GnRH antagonist cycles. Lower 2 pronuclear embryo rate (P = 0.038), and fewer high-quality embryos (P = 0.020) were encountered in patients with PL [47]. On the other hand, it was suggested that PL results from diminished ovarian reserve, and is more common in poor responders and older women [48].…”

Section: Patient Profilementioning

confidence: 99%

Revisiting debates of premature luteinization and its effect on assisted reproductive technology outcome

Hussein

Elnashar

Amin

et al. 2019

J Assist Reprod Genet

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The impact of the prematurely elevated serum progesterone on the late follicular phase, commonly known as premature luteinization (PL), is a matter of continuing debate. Available evidence supports that serum progesterone ≥ 1.5 ng/ml on the day of ovulation triggering could reduce the pregnancy potential in fresh in vitro fertilization (IVF) cycles by jeopardizing endometrial receptivity. Causes of PL during ovarian stimulation are unclear. Recent studies point toward the daily follicle-stimulating hormone dosage, duration of controlled ovarian stimulation, number of oocytes retrieved, and peak estradiol level as factors affecting the incidence of PL. Emerging data show additional influence on embryo quality. The prevention of PL has been challenging. The key elements in preventing PL include individualization of ovarian stimulation according to patient's ovarian reserve, proper ovulation trigger timing, and use of medications such as corticosteroids and metformin. Embryo cryopreservation with deferred embryo transfer is the established strategy to overcome PL, yet it is an extra burden to the IVF laboratory and increased cost for patients. Herein, we review the up-to-date knowledge of this frequent IVF problem including causes, proposed diagnostic criteria, and its impact on endometrial receptivity, embryo quality, and pregnancy outcomes. The preventive measures and rescue strategies are also discussed.

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The effect of premature luteinizing hormone increases among high ovarian responders undergoing a gonadotropin‐releasing hormone antagonist ovarian stimulation protocol

Abstract: Earlier administration of GnRH antagonist could avoid premature luteinizing hormone increases among high ovarian responders, especially those with a starting AFC of 22 or more.

Cited by 12 publications

References 25 publications

A Premature Rise of Luteinizing Hormone Is Associated With a Reduced Cumulative Live Birth Rate in Patients ≥37 Years Old Undergoing GnRH Antagonist In Vitro Fertilization Cycles

A Premature Rise of Luteinizing Hormone Is Associated With a Reduced Cumulative Live Birth Rate in Patients ≥37 Years Old Undergoing GnRH Antagonist In Vitro Fertilization Cycles

Effect of Interval between Human Chorionic Gonadotropin Priming and Ovum Pick-up on the Euploid Probabilities of Blastocyst

Revisiting debates of premature luteinization and its effect on assisted reproductive technology outcome

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